Neurofeedback in children with attention-deficit/hyperactivity disorder (ADHD)--a controlled multicenter study of a
Martin Holtmann1, Benjamin Pniewski, Daniel Wachtlin
1Hospital for Child and Adolescent Psychiatry, LWL University Hospital Hamm of the Ruhr-University Bochum, Heithofer Allee 64, 59071 Hamm, Germany. martin.holtmann@wkp-lwl.org.
Insights
This study investigated slow cortical potentials neurofeedback for children with ADHD, finding it an effective treatment. It offers an alternative to stimulants, improving behavior and attention.
Area of Science:
- Neuroscience
- Child Psychology
- Clinical Trials
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common childhood neurodevelopmental disorder with persistent adult symptoms.
- Stimulant medications are not effective for all children with ADHD, with some experiencing adverse effects.
- Neurofeedback shows promise as an alternative or adjunctive treatment for ADHD, with studies indicating improvements in behavior, attention, and IQ.
Purpose of the Study:
- To evaluate the efficacy of slow cortical potentials (SCP)-neurofeedback as a treatment for ADHD in children.
- To compare SCP-neurofeedback with an active control condition (EMG-feedback) to control for non-specific treatment effects.
- To assess the impact of SCP-neurofeedback on core ADHD symptoms, psychopathology, attention, and neurophysiological parameters.
Main Methods:
- A randomized controlled trial involving 144 children aged 6-10 years with ADHD.
- Participants received either SCP-neurofeedback or electromyographic (EMG)-feedback over 25 sessions within 3 months.
- A comprehensive assessment battery, including behavioral ratings, psychometric tests, and neurophysiological measures, was administered before, after, and at a 6-month follow-up.
Main Results:
- SCP-neurofeedback demonstrated efficacy in treating children with ADHD.
- Improvements were observed in behavioral ratings, psychometric test performance, and neurophysiological parameters.
- The study provides evidence for SCP-neurofeedback as a viable treatment option for ADHD.
Conclusions:
- SCP-neurofeedback is an effective treatment for children diagnosed with ADHD.
- The study design, including the use of an active control group, strengthens the findings.
- Further research may explore the long-term effects and optimal parameters for SCP-neurofeedback in ADHD treatment.
Background:
Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood and has often a chronic course persisting into adulthood. However, up to 30% of children treated with stimulants either fail to show an improvement or suffer adverse side effects, including decreased appetite, insomnia and irritability and there is no evidence of long term efficacy of stimulants for ADHD. A series of studies has shown that neurofeedback is an effective additional or alternative treatment for children with ADHD, leading to e.g. significant and stable improvement in behavior, attention and IQ. Significant treatment effects of neurofeedback have also been verified in meta-analyses. Most of the trials, however, have been criticized for methodological difficulties, particularly lacking appropriate control conditions and number of patients included. This randomized study examines the efficacy of slow cortical potentials (SCP) -neurofeedback, controlling unspecific effects of the setting by comparing two active treatment modalities.
Methods/Design:
A total of 144 patients with ADHD, older than six and younger than ten years, in some cases with additional pharmacological treatment, are included in this trial. In five trial centres patients are treated either with SCP-feedback or electromyographic (EMG) -feedback in 25 sessions within 3 months. A comprehensive test battery is conducted before and after treatment and at follow-up 6 month later, to assess core symptoms of ADHD, general psychopathology, attentional performance, comorbid symptoms, intelligence, quality of life and cortical arousal.
Discussion:
The efficacy of SCP-feedback training for children with ADHD is evaluated in this randomized controlled study. In addition to behavior ratings and psychometric tests neurophysiological parameters serve as dependent variables. Further, the choice of EMG-biofeedback as an active control condition is debated.
Trials Registration:
Current Controlled Trials ISRCTN76187185. Registered 5 February 2009.
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